Provider Demographics
NPI:1033260948
Name:OLSON, SHELLEY BARKER (DDS)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:BARKER
Last Name:OLSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-2552
Mailing Address - Country:US
Mailing Address - Phone:919-693-4090
Mailing Address - Fax:
Practice Address - Street 1:1104 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-2552
Practice Address - Country:US
Practice Address - Phone:919-693-4090
Practice Address - Fax:919-693-9255
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC74051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice